AI Article Synopsis
- Tc-pyrophosphate myocardial scintigraphy (Tc-PYP) can help diagnose transthyretin cardiac amyloidosis (ATTR-CA), but false positives can arise from tracer buildup in the blood.
- A study analyzed 164 patients using Tc-PYP imaging and found that the heart-to-mediastinum (H/M) ratio effectively distinguishes ATTR-CA from non-ATTR-CA cases.
- The H/M ratio greater than 1.41 demonstrated excellent diagnostic accuracy with 100% sensitivity, suggesting it could serve as a reliable new indicator for ATTR-CA diagnosis.
Article Abstract
Background: In transthyretin cardiac amyloidosis (ATTR-CA), Tc-pyrophosphate myocardial scintigraphy (Tc-PYP) is a diagnostic tool that utilizes visual and quantitative evaluation. However, false positive cases can occur because of tracer accumulation in the blood. We investigated the effectiveness of the heart-to-mediastinum (H/M) ratio of Tc-PYP in ATTR-CA diagnosis.
Methods: We retrospectively included 164 patients who underwent Tc-PYP single-photon emission computed tomography/computed tomography between March 2019 and January 2022. The diagnostic accuracy of ATTR-CA was examined by the heart-to-contralateral lung (H/CL) and H/M ratio calculated at 3 hours post-tracer administration.
Results: After the exclusion of patients who did not undergo endomyocardial biopsy, 30 patients (15 each with ATTR-CA and without ATTR-CA) were included. The receiver operating characteristic curve used to distinguish ATTR-CA from non-ATTR-CA patients revealed an area under the curve of 0.986 and 0.943, respectively. A H/M ratio of > 1.41 identified ATTR-CA patients with a sensitivity, specificity, positive predictive value (PPV), and negative predictive value (NPV) of 100, 93.3, 93.3, and 100%, respectively. Conversely, an H/CL ratio of > 1.3 identified ATTR-CA patients with 100% sensitivity, 40.0% specificity, 62.5% PPV, and 100% NPV.
Conclusion: The H/M ratio obtained at 3 hours post-injection has the potential to be a novel indicator for ATTR-CA.
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| http://dx.doi.org/10.1007/s12350-022-03180-5 | DOI Listing |
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